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Module 4 - Saliva > Disorders > Flashcards

Disorders Flashcards

1
Q

what is the failure to develop normally?

A

Aplasia

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2
Q

what is atresia?

A

failure of ducts to be tubular

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3
Q

what duct is most affected by aterisa?

A

submandibular

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4
Q

what does heterotopic mean?

A

out with normal region

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5
Q

what is a mucocoele?

A

cystic cavity filled with mucus

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6
Q

what are the 2 types of mucocoeles?

A

extravasation
retention

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7
Q

what is the clinical term for an extravasation mucocoele?

A

mucous extravasation cyst

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8
Q

what is the clinical term for a retention mucocoele?

A

mucous retention cyst

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9
Q

what are clinical features of a extravasation mucocoele?

A

bluish/ transparent swelling
asymptomatic

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10
Q

where would you normally find extravasation mucocoeles?

A

minor glands especially lower lip
children and young adults

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11
Q

aetiology of extravasation mucocoele?

A

trauma associated lesion
ruptured duct with leakage of saliva into surrounding connective tissue
leaked saliva elicits inflammation

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12
Q

what is the histopathology of a extravasation mucocoele?

A
  • Cystic cavity filled with mucin in connective tissue.
  • Mucin surrounding by inflamed granulation tissue, typically with lots of macrophages.
  • Not classed as a true cyst as no epithelial lining.
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13
Q

what is the treatment for a extravasation mucocoele?

A

removal of all mucocoele by excision with associated ruptured duct and gland where possible to prevent recurrence.

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14
Q

what are clinical features of a retention mucocoele?

A

similar to extravasation
rare on lower lip

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15
Q

aetiology of retention mucocoele?

A

cystic dilation of duct due to obstruction
affects minor and major glands

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16
Q

what is the histopathology of a retention mucocoele?

A
  • Mucin retained with a dilated duct.
  • Cyst lining is epithelial lining of the duct.
  • As saliva is retained within the duct and doesn’t escape, there is less inflammation.
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17
Q

what is the treatment of a retention mucocoele?

A

excision

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18
Q

clinical features of a ranula?

A

painless soft blush swelling on FOM
can present as swelling in the neck

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19
Q

what is it called when a ranula presents as swelling in the neck?

A

plunging ranula

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20
Q

what is treatment for a ranula?

A

drainage of the cystic cavity and removal of sublingual gland

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21
Q

what is sialadenitis?

A

inflammation of salivary glands

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22
Q

what glands are mostly affected by acute bacterial sialadenitis?

A

parotid

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23
Q

clinical features of acute bacterial sialadenitis?

A

pain
swelling
tenderness
exudation of pus
redness overlying skin

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24
Q

what is a predisposing factor of acute bacterial sialadenitis?

A

decreased salivary flow

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25
Q

what pathogens are associated with acute bacterial sialadentitis?

A

Staphylococcus aureus, Streptococci, and oral anaerobes.

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26
Q

clinical features of chronic bacterial sialadentitis?

A

swelling, pain, redness, and tenderness
unilateral
asymptomatic or intermittent painful swelling (usually mealtimes)

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27
Q

what gland is most affected by chronic bacterial sialadentitis?

A

submandibular

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28
Q

what are salivary calculi known as?

A

sialoliths/ stones

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29
Q

what is chronic bacterial sialadenitis secondary to?

A

duct obstruction caused by stones

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30
Q

what glands are most affected by salivary calculi?

A

submandibular

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31
Q

aetiology of salivary calculi?

A

mineralisation of phosphates from supersaturated saliva being deposited around central nidus of cell debris.

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32
Q

where may calculi form?

A

within ducts
main excretory duct

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33
Q

presentation of salivary calculi?

A

vary in size
round or ovoid
rough or smooth
yellow

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34
Q

how is inflammation elicited with salivary calculi?

A

bacteria grow on surface

35
Q

clinical features of salivary calculi?

A

no symptoms until stone obstructed:
unilateral swelling/ pain often at mealtimes

36
Q

predisposing factors of salivary calculi?

A

dry mouth
dehydration

37
Q

treatment of salivary calculi?

A

remove or breakdown some stones or remove the gland if it has become damaged with longstanding infection

38
Q

histopathology of sialadenitis?

A
  • Salivary acini become atrophic and are replaced by fibrous scar tissue.
  • Salivary ducts within gland dilate and there is often hyperplasia of duct epithelium.
  • Chronic inflammatory infiltrate with plasma cells and lymphocytes is seen in the gland.
39
Q

in sialadenitis, what results in a mass in the gland commonly mistaken for a neoplasm?

A

progressive chronic inflammation resulting in replacement of salivary parenchyma by fibrous tissue

40
Q

treatment of sialadenitis?

A

is mild the gland may recover
if extensive excise the gland

41
Q

what is mumps?

A

viral sialadenitis - Acute, contagious infection caused by paramyxovirus which spreads via saliva

42
Q

clinical features of mumps?

A
  • Painful swelling of parotids and other exocrine glands.
  • Fever, headache, and malaise.
43
Q

vaccine for mumps?

A

MMR vaccine

44
Q

complications of mumps?

A

orchitis, oophoritis, nephritis

45
Q

what may be the first sign of HIV from the mouth?

A

HIV-associated salivary gland disease

46
Q

clinical features of HIV associated SGD?

A
  • Inflammation of major glands (parotid)
  • May be bilateral.
  • Painful and soft to palpate.
  • Multiple cysts are seen on imaging of glands.
47
Q

histopathology of HIV-associated SGD?

A

multiple large cysts and dense lymphoid tissue.

48
Q

Clinical features of necrotising sialometaplasia?

A
  • Large, deep ulcer.
  • Painful
49
Q

what does necrotising sailometaplasia affect?

A

minor salivary glands
hard palate

50
Q

aetiology of necrotising sailometaplasia?

A

uncertain but likely to be due to ischaemia. Infarction secondary to trauma

51
Q

histopathology of necrotising sailometaplasia?

A
  • Necrosis of salivary acini
  • Inflammation and hyperplasia/ metaplasia of salivary ducts.
52
Q

why may sailometaplasia be mistaken for cancer?

A

change in duct epithelium

53
Q

treatment for necrotising sailometaplasia?

A

none - heals on own

54
Q

what is Sjogrens syndrome?

A

Autoimmune disease of unknown cause characterised by lymphocytic infiltration and acinar destruction of lacrimal and salivary glands (and other exocrine glands).

55
Q

symptoms of primary SS?

A

dry eyes and mouth with no associated connective tissue disease.

56
Q

symptoms of secondary SS?

A

dry eyes and mouth and a connective tissue disease e.g., Rheumatoid Arthritis.

57
Q

Whos most affected by SS?

A

Middle aged
females

58
Q

clinical features of SS?

A

fatigue, joint pain, peripheral neuropathy

59
Q

complications of SS?

A

dry mouth - caries, perio disease, swallowing and speech difficulty
eye problems

60
Q

what does SS increase risk of?

A

developing lymphoma in affected glands

61
Q

diagnostic test for SS?

A

labial gland biopsy from lower lip

62
Q

how many glands are sampled for SS biopsy?

A

5-8 minor glands

63
Q

what is sialadenosis?

A

Non-inflammatory, non-neoplastic, bilateral symmetrical swelling of salivary glands.

64
Q

what glands are most affected by sialadenosis?

65
Q

symptoms of sialadenosis?

A

painless
bilateral salivary gland swelling

66
Q

what is sialadenosis associated with?

A

malnutrition, anorexia, bulimia, alcoholism, DM, certain drugs and hormone disturbance

67
Q

what does sialadenosis result in?

A

hypertrophy or serous acini

68
Q

where is salivary gland tumours most common?

A

major glands - parotid

69
Q

in salivary gland tumours in minor glands, where are most found?

A

palate
upper lip

70
Q

where is the proportion of carcinomas highest?

A

minor salivary glands

71
Q

what are the diagnostic techniques for determining oral cancer?

A

fine needle aspiration
core biopsy
open biopsy
excision

72
Q

what are the WHO classifications of salivary gland tumours?

A
  1. Malignant tumours
  2. Benign tumours
  3. Non-neoplastic epithelial lesions
  4. Benign soft tissue lesions
  5. Haematolymphoid tumours
73
Q

what are mucoepidermoid carcinomas?

A

epithelial salivary gland malignant tumours

74
Q

where are mucoepidermoid carcinomas common?

A

parotids
females

75
Q

what do 80% of mucoepidermoid carcinomas have?

A

MAML2 gene fusions

76
Q

histopathology of mucoepidermoid carcinomas?

A

Tumour is encapsulated and displays an infiltrative pattern of growth, consisting of variable proportions of 3 types of tumour cells.

Tumours with high mucous cells numbers tend to be cystic whereas mainly epidermoid lesions tend to be more solid and aggressive.

77
Q

what are the 3 types of tumour cells in mucoepidermoid carcinomas?

A
  • Mucous secreting cells
  • Epidermoid (squamoid) cells
  • Intermediate cells.
78
Q

treatment of mucoepidermoid carcinoma?

A

complete excision of tumour

79
Q

what is the most common salivary gland tumour?

A

pleomorphic adenoma

80
Q

clinical features of pleomorphic adenoma?

A

benign
painless
slow growing
rubber lump

81
Q

what gene rearrangements is pleomorphic adenoma associated with?

A

PLAG1
HMGA2

82
Q

Histopathology of pleomorphic adenoma?

A
  • Well-circumscribed tumour
  • Incomplete fibrous capsule (tumour nodules can extend through capsule).
  • May be cystic.
  • Complex intermingling of epithelial and myoepithelial components.
  • Tumour epithelial cells differentiate to connective tissue type and can form connective tissue e.g., cartilage, bone.
83
Q

treatment of pleomorphic adenoma?

A

complete excision (highly recurrent if not completely).

84
Q

what is a carcinoma ex pleomorphic adenoma?

A

malignant transformation in pleomorphic adenoma in long standing lesion

Module 4 - Saliva (7 decks)

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